In Soviet Asia Backwater, Infancy's a Rite of Survival

By ESTHER B. FEIN, Special to The New York Times

Published: August 14, 1989

CHIMBAI, U.S.S.R.—
This is the dying season here, the time of year when the flowering birth rates in Soviet Central Asia are tempered by the number of babies who die before reaching their first birthdays.

The infants die hours after birth, many of them born undernourished from the wombs of undernourished mothers who have taken too little time between babies. They die at several weeks or months of age, when their frail, anemic bodies can no longer sustain life, or when they catch diseases they are too weak to fight.

They die here in the Karakalpak Autonomous Republic, on the shores of the Aral Sea, at the highest rate in the Soviet Union -cursed before birth by poor family planning, the region's contaminated water supply, its abominable sewage system, its unsanitary hospitals. Brutal Summer Heat

For every 1,000 babies born here, about 60 die, an infant-mortality rate comparable to those of Cameroon and Guatemala. While the Soviet Union's national rate of infant mortality is just under 25 per 1,000, in one Karakalpak region it is 111 per 1,000. And the babies die in the greatest numbers now, when the brutal summer heat worsens already bad conditions.

The statistics embarrass officials, frighten doctors and shock outsiders who do not realize that the Soviet Union, despite its prominence as a political and military power, has many regions where living standards are as primitive as in underdeveloped countries. 'Our National Shame'

''For the longest time, this country paid no attention to health care, especially to the health of women and children,'' said Dane Rein, the Deputy Minister of Health in Karakalpak. ''It is our national shame that our country is so wealthy, yet so many of our babies are dying.''

The Soviet authorities, in their efforts to revive the country's economy and raise the standard of living, face social problems neglected or inadequately attacked by previous leaders: unemployment, poor housing conditions and the lack of consumer goods, among others.

Infant mortality is widely considered one of the most critical barometers of the quality of a country's health care. The staggering rates at which babies die here in Central Asia emphasize just how disheartening is the struggle to improve Soviet society as a whole after decades of mismanagement, corruption and of central planning in a country with such diverse regions and problems.

Last year's Soviet infant-mortality rate - just under 25 deaths per 1,000 births, according to Soviet figures -places the country in the same category as Panama. In the United States, by comparison, the rate last year was just under 10 per 1,000, although there too the rate is higher in poor or remote areas; in the District of Columbia the infant mortality is 21.1 deaths per 1,000 live births, worse than any state in the nation.

Western experts estimate that the real Soviet infant-mortality figure is probably about 14 percent higher than the official figure, considering underreporting and differences in criteria worldwide for determining what is a live birth and which infants are considered stillborn.

The numbers are alarming, but they actually represent an improvement -though a very slight one - over the figures for the last three years, since Soviet authorities started sending brigades of doctors and medical workers to Central Asia and Kazakhstan for these critical summer months. In addition, the Soviet Children's Fund, a two-year-old organization supported by both public and private money, this year sent doctors to these republics for three-year terms specifically to monitor and improve the health of mothers and babies.

''It's such a simple goal - to save children,'' said Valery P. Danilov, an epidemiologist and one of the children's fund doctors in Karakalpak. ''But there are such complex, social, medical, economic and ecological problems that can not be erased so easily.'' Polluted Waters Infect Weakest Infants It is no accident that Karakalpak has the worst infant-mortality rate in the Soviet Union.

This region, which has a population of 1.2 million and is administered by the Uzbek government in Tashkent, hugs the southern part of the Aral Sea. Soviet authorities have diverted its waters to irrigate the cotton fields of Uzbekistan, Turkmenia and Karakalpak. As a result, the sea has been shrinking and its pollutants have been condensed. The two rivers that feed it, the Amu Darya and Syr Darya, have been turned into little more than sewers. This contaminated water, often the only water for residents here, spreads infection and disease, especially among the weakest infants.

Moreover, the chemical pesticides and defoliants used in cotton growing here are absorbed by the men and women who work the fields and are washed into the river water they drink.

A government commission has been established to save the sea and there are plans to build water supply systems, but meanwhile, with no short-term provisions, the water remains tainted. An article in the newspaper Socialist Industry said a recent study found that mothers living in the Aral Sea area - ''without exception'' -have chemical pesticides in their breast milk.